MBF/Miami Produce Center Scholarship Application MBF/Miami Produce Center Scholarship Application Step 1 of 5 20% APPLICANT DATAMr.Ms.Name* First Middle Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code You must reside in the Allapattah neighborhood in the City of Miami (see map provided in Conditions of Eligibility). Cell Phone*Home PhoneEmail* Ethnicity/Race PARENT DATAIf you are under 21, please fill out the following.Mr.Ms.Mrs.Name First Middle Last Cell PhoneEmail Address (If different from applicant’s address) Same as previous Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code HIGH SCHOOL DATA(If graduated in last 12 months)Cumulative GPA (weighted) School Name School PhoneSchool Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Principal’s Name Expected Graduation DateExpected Graduation Date MM slash DD slash YYYY COLLEGE DATAWhich College will you be or are you currently attending?* Which Program?* Expected Start Date*Expected Start Date MM slash DD slash YYYY Expected Graduation/Completion Date*Expected Graduation/Completion Date MM slash DD slash YYYY Special Note: Applicants must meet all eligibility requirements and submit an official transcript of grades School, Community Service Activities, Work Experience, and EssayList all School and Community Activities for the Last Two YearsList all School and Community Activities for the Last Two YearsActivityYearsHonors/Award List all Work Experience for the Last Two YearsList all Work Experience for the Last Two Years Statement of Goals and AspirationsStatement of Goals and Aspirations*Use this space to write a statement that reflects your dedication to scholarship and your participation and excellence in both school and community activities. Additionally, state why you wish to continue your education; define your career goals and your plan for achievement.Upload ALL Required DocumentsUpload ALL Required Documents*1. Current College Registration (Fee Invoice) 2. Unofficial Transcripts If you are unable to upload all the documents, please email them to alan@mbf.miami. Drop files here or Select files Max. file size: 64 MB. * By checking this box, I consent to be contacted by the Miami Bayside Foundation, including by email or calls, about my interest in the MBF/Miami Produce Center Scholarship. * By checking this box, I affirm that all the information provided in this application and supporting documents is true and complete to the best of our knowledge. If requested, we will provide proof. Failure to do so shall invalidate this application and result in the termination of any aid granted. Signature of Applicant (Type Name)* Type Name in FieldSignature of Parent/Guardian (if under 21) Type Name in FieldNote: Your request becomes valid only when this application and all supporting documents are submitted to the Miami Bayside Foundation.
